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Thromb Haemost 2005; 93(03): 564-569
DOI: 10.1160/TH04-11-0708
Cell Signalling and Vessel Remodelling
Schattauer GmbH

–455 G/A polymorphism and preprocedural plasma levels of fibrinogen show no association with the risk of clinical restenosis in patients with coronary stent placement

Pascalle S. Monraats
1   Department of Cardiology, Leiden University Medical Center, The Netherlands
2   Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, The Netherlands
,
Jamal S. Rana
1   Department of Cardiology, Leiden University Medical Center, The Netherlands
3   Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands
,
Aeilko H. Zwinderman
4   Department of Medical Statistics, Academic Medical Center, Amsterdam, The Netherlands
,
Moniek P. M. de Maat
5   Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands
,
John P. Kastelein
3   Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands
,
Willem R. P. Agema
1   Department of Cardiology, Leiden University Medical Center, The Netherlands
2   Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, The Netherlands
,
Pieter A. F. Doevendans
6   Department of Cardiology, University Medical Center Utrecht, The Netherlands
,
Robbert J. de Winter
7   Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands
,
René A. Tio
8   Department of Cardiology, Academic Hospital Groningen, The Netherlands
,
Johannes Waltenberger
9   Department of Cardiology, Academic Hospital Maastricht, The Netherlands
,
Rune R. Frants
10   Department of Human Genetics, Center for Human and Clinical Genetics, Leiden University Medical Center, The Netherlands
,
Arnoud van der Laarse
1   Department of Cardiology, Leiden University Medical Center, The Netherlands
,
Ernst E. van der Wall
1   Department of Cardiology, Leiden University Medical Center, The Netherlands
,
J. Wouter Jukema
1   Department of Cardiology, Leiden University Medical Center, The Netherlands
2   Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, The Netherlands
› Author AffiliationsGrant support: Pascalle Monraats and Dr. Agema are supported by grant 99.210 from the Netherlands Heart Foundation and a grant from the Interuniversity Cardiology Institute of the Netherlands (ICIN). Dr. J. W. Jukema is an Established Clinical Investigator of the Netherlands Heart Foundation (2001 D 032).
Further Information

Publication History

Received 02 November 2004

Accepted after resubmission 16 February 2004

Publication Date:
14 December 2017 (online)

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Summary

The effect of preprocedural fibrinogen levels on in-stent restenosis is largely unknown. The –455 G/A polymorphism of the fibrinogen β-gene is associated with baseline plasma level or acute phase increase of fibrinogen. Therefore, we hypothesized that there is a relationship between this polymorphism and pre-procedural fibrinogen level and clinical restenosis at follow-up among patients with coronary stent placement. The GENetic DEterminants of Restenosis (GENDER) project is a multicenter follow-up study that enrolled 3,146 consecutive patients after successful percutaneous coronary intervention. A coronary stent was placed in 2,309 patients. Of these, 2,257 (97.7%) patients were successfully genotyped for the –455G/A polymorphism. Plasma fibrinogen levels were measured at baseline in a subpopulation of 623 stented patients with the von Clauss method and patients were grouped into tertiles according to fibrinogen levels. Primary endpoint was target vessel revascularization (TVR); secondary combined endpoint was defined as death presumably from cardiac causes, MI not attributable to another coronary artery than the target vessel, and TVR. No association was observed between the –455G/A polymorphism and TVR or combined endpoint (p=0.99, p=0.97, respectively). Multivariate regression analysis revealed that the risk of TVR and combined endpoint was not higher for patients in the highest tertile for fibrinogen versus the lowest tertile (RR=0.60, 95% CI: 0.26–1.37 for TVR, RR=0.64, 95% CI: 0.29–1.44 for combined endpoint). In conclusion, the presence of –455G/A polymorphism in the fibrinogen β-gene and preprocedural fibrinogen level is not associated with an increased risk of TVR or combined endpoint in a patient population with coronary stent placement. Therefore, these parameters are not worthwhile for stratifying patients at risk for restenosis prestenting.

Keywords

Fibrinogen - coronary stent - restenosis - genetics
 

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